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European medicine and a great number of journalsand pamphlets. All the six libraries described in theRockefeller report are, indeed, conducted with thehighest kind of medical knowledge in view and on themost advanced modern principles.The medical profession is perhaps better supplied

than any other with exhaustive catalogues andlibrary helps of every kind. In the fine library ofthe Harvard Medical School there are some 45,000volumes, over 100,000 pamphlets, and the number ofcurrent periodicals is over 400. But the student isnot left at sea among all this, for the attendantsin all the rooms answer all inquiries and try theirutmost to supply the information desired." Thelibrarians, Dr. Elliott P. Joslin and Frances Whitman,"take pleasure in giving assistance." We can wellbelieve it, and the same may be said of medicallibrarians all the world over. The library of theWashington School of Medicine, St. Louis, under theskilled management of Miss Etta Lawrence, nownumbers well over 33,000 volumes, having risen froma nucleus of 3000 volumes in 1910. Unlike most verymodern collections, this admirable library, ’ classedwith the best libraries of medical schools," possessesantiquities in the shape of the Beaumont Collections.These consist chieflv of the note-books in which foryears Dr. William Beaumont, the pioneer Americanphysiologist who was also F.R.C.S. England, set downhis observations of the workings of the gastric juicethrough the fistula in the abdomen of Alexis St. Martin.A library which promises very well, though it is atpresent small, is that of the Queen’s University,Kingston, Ontario. It forms part of the largeuniversity library of 175.000 volumes. At McGillUniversity the medical collection is extensive, amount-ing to some 60,000 volumes. It is more than acentury old, having been founded in 1823. In 1907 theOsler Library was erected, and here are housed the7000 odd volumes, which it was the life-work of thatfine bibliophile, Sir William Osler, to collect. TheOsler Library has a hoble appearance worthy of himwhom it commemorates. The Rockefeller Foundationhas issued the report in pamphlet form, as the sixthinstalment of a larger work, which will doubtlesscontain descriptions of the famous medical libraries ofLondon and of the Surgeon-General’s Library atWashington, as well as of those of the Continent ofEurope.

ADDITIONAL INSURANCE BENEFITS.THERE is gratifying evidence that the scheme of the

Insurance Acts is now being developed along preven-tive lines. Last month, in reply to a question by SirJohn Power in the House of Commons, the Ministerof Health gave some interesting figures showing theextent of additional benefits granted to insuredpersons during the year 1926 (THE LANCET, April23rd, p. 901). During this twelvemonth a sum

of more than one million pounds was expended ondental treatment and nearlv a quarter of a million ontreatment in hospitals. Much of this dental treat-ment is of a preventive nature and, along with themedical inspection of school-children and dentaltreatment at school clinics. it cannot fail to react inthe course of time on the incidence of sickness. Theamount spent on treatment in hospitals and theE7000 on provision of nurses might well have beenmuch larger, for both of these are essential servicesfor the restoration of the sick worker to normal health.No information was given as to the amount of addi-tional benefit given by way of increase in the ordinarycash benefits, and so no material is available to judgewhat relation this outlay bears to the one-and-a-halfmillions spent on specified additional benefits, butit is to be hoped that the latter fund will go onincreasing, when there will soon be manifest someimprovement in the efficiency of the workers and somereduction in the time lost from incapacity. Thefigures given by the Minister of Health are evidencethat the problem of preventing sickness is beingseriously tackled by the approved societies.

Annotations.

THE BRINE BATHS OF DROITWICH.

"Ne quid nimis."

THE ancient township of Droitwich lies in a hollowof the beautiful Worcestershire hills, and 200 feetbeneath it is the inexhaustible bed of salt which has.provided brine for commercial and therapeutic usesince Roman times. The water, which used to wellup to the surface but now has to be pumped, is uniqueamong the mineral springs of the world in its con-centration--ten times stronger than sea-water, 40 percent. stronger than the waters of the Dead Sea, andamong mineral springs approached only by those ofRheinfelden and Bex in Switzerland. The water isonly available on the spot, for Droitwich believes,with much show of reason, that the full effects ofthe brine cannot be obtained from redissolving theevaporated salt, and that the high degree of radio-activity present in the fresh brine would be dissipatedby evaporation or during long transit. There is little,if any, accurate knowledge as to the precise actionof brine baths on the various systems of the body.Salt-water baths are reputed to have a much morestimulant effect than have ordinary baths of the sametemperature, and Droitwich repeats in season (andperhaps out of season) the story of the rediscoveryof the stimulating properties of the brine when thecontents of an evaporation pan were used in emergencyfor a collapsed cholera patient a century ago. Theinfluence of salt water on metabolism has been thesubject of much experiment and discussion, but, asDr. Huggard said 20 years ago,l no very positiveconclusions have been obtained, and the same ir,largely true at the present time. Testimony to thechemical activity of the brine is borne by the corrodedtaps and discoloured walls of the old baths, whichthe new installation completely masks by its vulcanitefittings and vitrolite panels. The buoyancy of thewater is such that the immersed body or limb iscompletely supported, so that stitf and partlyparalysed muscles are enabled to move on their owninitiative with little expenditure of energy. Activemovement of this kind is a unique feature of thebrine bath, and var-time experience not only sug-gested its great utility but the possibility of its takingthe place to a large extent of massage and passivemovement. The doctors of Droitwich are aU busygeneral practitioners, with little time to devote tothe why or the how of the good results of which theyare daily u-itness, and at his visit last week, recordedon another page, Mr. Neville Chamberlain gentlychid them for an omission which may be preventingDroitwich from being useful on the scale which itmerits. Mr. Chamberlain was careful to explainthat he was speaking as one of the trustees of theCorbett Estate, to which the bathing establishmentsbelong, and not as Minister of Health ; but the localmedical profession will do well to take his words toheart and in the course of time provide good evidencefor the faith which is in them. There should, at allevents, he no lack of occupation for a full-time

I biochemist at Droitwich.SPLANCHNIC ANALGESIA.

SPLANCHNIC analgesia has been in use since 1914,when M. Kappis first reported on it at the SurgicalCongress at Berlin. Since then H. Braun (1919) andG. Labat have made important additions to theliterature of the subject. In our own columns 2 arecord of 91 cases has been published by O. S. Hillmanand B. E. Apperley. There has been time, there-fore. for the technique of the method to besystematically and thoroughly established and for its

1 A Handbook of Climatic Treatment including Balneology.By W. R. Huggard. Macmillan and Co., 1906.

2 THE LANCET, 1925, i., 863.